The effect of Aliskiren on exercise capacity in older patients with heart failure and preserved ejection fraction: A randomized, placebo-controlled, double-blind trial.

In older patients (70 ± 7 years) with chronic well-compensated heart failure with preserved ejection and controlled blood pressure, 6 months treatment with aliskiren (direct renin inhibitor) showed non-significant trends for modest improvements in peak exercise oxygen consumption (14.9 ± 0.2 mL kg min versus 14.

Effect of Spironolactone on Exercise Tolerance and Arterial Function in Older Adults with Heart Failure with Preserved Ejection Fraction.

Objectives: To evaluate the effects of an aldosterone antagonist on exercise intolerance in older adults with heart failure and preserved ejection fraction (HFpEF).

Design: Randomized, placebo-controlled, double-blind trial.

Setting: Academic medical center, Winston-Salem, North Carolina.

Association Between 6-Minute Walk Test Distance and Objective Variables of Functional Capacity After Exercise Training in Elderly Heart Failure Patients With Preserved Ejection Fraction: A Randomized Exercise Trial.

Objective: To evaluate the change in the 6-minute walk test (6-MWT) distance relative to changes in key functional capacity measures after 16 weeks of exercise training in older patients (≥65y) who have heart failure with preserved ejection fraction (HFpEF).

Design: Prospective, randomized, single-blinded (by researchers to patient group) comparison of 2 groups of HFpEF patients.

Setting: Hospital and clinic records; ambulatory outpatients.

Effect of endurance exercise training on endothelial function and arterial stiffness in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.

Objectives: The study sought to evaluate the effects of endurance exercise training (ET) on endothelial-dependent flow-mediated arterial dilation (FMD) and carotid artery stiffness, and their potential contributions to the training-related increase in peak exercise oxygen consumption (Vo2) in older patients with heart failure with preserved ejection fraction (HFPEF).

Background: Elderly HFPEF patients have severely reduced peak Vo2, which improves with ET, however, the mechanisms of this improvement are unclear. FMD and arterial distensibility are critical components of the exercise response and are reduced with aging.

Effect of endurance training on the determinants of peak exercise oxygen consumption in elderly patients with stable compensated heart failure and preserved ejection fraction.

Objectives: The purpose of this study was to evaluate the mechanisms for improved exercise capacity after endurance exercise training (ET) in elderly patients with heart failure and preserved ejection fraction (HFPEF).

Background: Exercise intolerance, measured objectively by reduced peak oxygen consumption (VO(2)), is the primary chronic symptom in HFPEF and is improved by ET. However, the mechanisms are unknown.

Determinants of exercise intolerance in elderly heart failure patients with preserved ejection fraction.

Objectives: The purpose of this study was to determine the mechanisms responsible for reduced aerobic capacity (peak Vo(2)) in patients with heart failure with preserved ejection fraction (HFPEF).

Background: HFPEF is the predominant form of heart failure in older persons. Exercise intolerance is the primary symptom among patients with HFPEF and a major determinant of reduced quality of life.

Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial.

Background: Heart failure (HF) with preserved left ventricular ejection fraction (HFPEF) is the most common form of HF in the older population. Exercise intolerance is the primary chronic symptom in patients with HFPEF and is a strong determinant of their reduced quality of life (QOL). Exercise training (ET) improves exercise intolerance and QOL in patients with HF with reduced ejection fraction (EF).

A randomized double-blind trial of enalapril in older patients with heart failure and preserved ejection fraction: effects on exercise tolerance and arterial distensibility.

Background: Exercise intolerance is the primary symptom in older patients with heart failure and preserved ejection fraction (HFPEF); however, little is known regarding its mechanisms and therapy.

Methods And Results: Seventy-one stable elderly (70+/-1 years) patients (80% women) with compensated HFPEF and controlled blood pressure were randomized into a 12-month follow-up double-blind trial of enalapril 20 mg/d versus placebo. Assessments were peak exercise oxygen consumption; 6-minute walk test; Minnesota Living with HF Questionnaire; MRI; Doppler echocardiography; and vascular ultrasound.

Endurance exercise training in older patients with heart failure: results from a randomized, controlled, single-blind trial.

Objectives: To test the hypothesis that exercise training (ET) improves exercise capacity and other clinical outcomes in older persons with heart failure with reduced ejection fraction (HfrEF).

Design: Randomized, controlled, single-blind trial.

Setting: Outpatient cardiac rehabilitation program.

VE/VCO2 slope in older heart failure patients with normal versus reduced ejection fraction compared with age-matched healthy controls.

Background: Oxygen consumption (VO2) has previously been used for prognosis and risk stratification in patients with heart failure. More recent research has introduced VE/VCO2 slope as a prognostic measure. Risk of mortality is thought to increase when VE/VCO2 slope values are greater than 34.

Leg flow-mediated arterial dilation in elderly patients with heart failure and normal left ventricular ejection fraction.

Background: flow-mediated arterial dilation (FMAD), an indicator of endothelial function, is reduced in patients with heart failure and reduced left ventricular ejection fraction (HFREF). Many elderly patients with heart failure exhibit a normal left ventricular ejection fraction (HFNEF). It is unknown whether FMAD is severely reduced in the elderly with HFNEF.

The relationship of a 6-min walk to VO(2 peak) and VT in older heart failure patients.

Purpose: To evaluate the relationship between a 6-min walk test (6-MWT) to peak oxygen consumption (VO(2 peak)) and ventilatory threshold (VT) in older heart failure (HF) patients, to validate the equation by Cahalin et al., and to develop a new equation to improve the prediction of VO(2 peak) from 6-MWT.

Methods: Older patients (>65 yr) with systolic or diastolic HF (N=97) performed an exercise test to peak exertion on an upright bicycle ergometer using an incremental protocol.

Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure.

Context: Many older patients with symptoms of congestive heart failure have a preserved left ventricular ejection fraction (LVEF). However, the pathophysiology of this disorder, presumptively termed diastolic heart failure (DHF), is not well characterized and it is unknown whether it represents true heart failure.

Objective: To assess the 4 key pathophysiological domains that characterize classic heart failure by systematically performing measurements in older patients with presumed DHF and comparing these results with those from age-matched healthy volunteers and patients with classic systolic heart failure (SHF).